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Independents' Day

Senior primary care and racism experts condemn ‘whitewashed’ PHE report

Criticism is mounting over the Government review looking at the disproportionate risk to black, Asian and minority ethnic people from Covid-19, with primary care and racism experts labelling it a ‘whitewash’.

The final document, published on Tuesday by Public Health England, concluded people of Bangladeshi origin are most at risk of dying from Covid-19 and that people from black ethnic groups were most likely to be diagnosed with the disease.

But media reports have suggested a key section was removed from previous versions and experts have said the lack of information on how to protect BAME people shows the Government is not taking the matter seriously.

It has been suggested that the redacted sections from the report included feedback from BAME representative groups, which had proposed BAME staff were more at risk due to discrimination and decisions made within organisations, including the NHS itself, according to a report in Health Service Journal.

GPs have said the statistics laid out in the report showing the higher risk of BAME people from the virus were already known and that the report lacks information on what steps to take next.

They have called on the Government to take action immediately and provide clear guidance on how BAME GPs and other staff can be protected.

PHE said the document had been published in full and that it would be seeking feedback before making recommendations.

Dr Ramesh Mehta, president of the British Association of Physicians of Indian Origin (BAPIO) told Pulse: ‘We believe that unfortunately, this is a complete whitewash. We were hoping it would come out with new information and solutions – but there is no information or solutions.

‘This is not new knowledge. We were expecting PHE to concentrate on giving advice to the BAME population on how to protect themselves.’

He noted the report contained no mention of key issues such as the use of personal protective equipment.

He added: ‘We hope this doesn’t get buried. There is no doubt there will be a second wave. Without precautionary measures, it will be catastrophic.’

Roger Kline, research fellow at Middlesex University and author of the 2014 ‘snowy white peaks’ report looking at discrimination in the NHS, also told Pulse: ‘This report doesn’t tell us anything new. It contains no recommendations even though its terms of reference said it would.

‘It doesn’t provide any explanation – it gives the data, but doesn’t explain why BAME people are more affected and you can’t draw out of it how to mitigate risks.

‘There’s nothing at all of the voices of those who have been impacted by this. It’s pointless and will irritate people.’

He said the lack of substance to the report suggested the Government was being dismissive of the additional risk to BAME people: ‘It [the lack of information in the report] says we aren’t taking this seriously.

‘This is at a time when the NHS is screaming for some reasonably authoritative explanation.’

Professor Aneez Esmail, a GP and academic at the University of Manchester, said the way the PHE analysis has been carried out in the report fails to provide the full picture by only providing death risk rates.

He said other factors, such as occupation, poverty and being more exposed to the virus, should be looked at alongside death rates.

Professor Esmail said: ‘There clearly is a difference between BAME and white populations when it comes to rates of death. But we need to be aware that the way this PHE analysis has been done still doesn’t give us a full picture.

‘People from BME backgrounds are overrepresented in frontline services – ie cab drivers, and bus drivers.

‘I think we will find that some GPs who died were unnecessarily put at risk, many of them were not working with proper PPE at the start of the pandemic and BME GPs are overrepresented in single handed practices.’

He added: ‘There is no gene for “ethnic minority”. The discrepancies are more to do with occupation, poverty and being more exposed to the virus.’

Dr Chandra Kanneganti, chair of the British International Doctors’ Association, said BIDA was demanding action.

He said: ‘We are writing to the equalities minister to ask for a timetable on when actions are going to be taken.

‘They have said they are going to be listening to stakeholders.

‘But the time isn’t for listening. We have already spoken. We want ideas about how we can protect doctors and healthcare workers. This has to happen in the next two weeks.’

Sir Sam Everington, a GP in east London and former adviser to NHS England, said the report was 'disappointing', adding: 'There is no central vision or plan. There’s no clear sense of what they’re [the Government] going to do. 

‘It’s entirely unacceptable [if the report has been redacted] and a big mistake. It creates mistrust.’

In a statement provided by PHE, Professor John Newton, regional director of public health at PHE, said the report contained ‘a great deal of background and detailed information we think will be helpful’.

He said: ‘What we would like to do is get a lot of discussion about all these with the various groups involved in responding to it.

‘It is not easy to go directly from the analysis to making recommendations and we need to get the report widely disseminated and discussed before deciding what needs to be done, but clearly there are some fairly obvious conclusions that can be drawn, even from the data we have.’

It comes as 10 out of 11 GPs to have died with Covid-19 so far in England were of BAME origin.

Readers' comments (14)

  • I'm staggered that anyone thought that a government review would actually come up with a solution. For now avoid F2F and make sure you are taking Vit D.

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  • Roger Kline (co-director NHS Workforce Race Equality Standard 2015-2017) "The real tragedy of this is that HC staff have died unnecessarily if the guidance coming out today had been put out when it should have been - 6 weeks ago, I don't think there's any doubt that large numbers of people might not have died. The discrimination in the NHS that happens is sometimes intentional, much of the time it's the culmination of small decisions which constitute institutional discrimination" Newsnight 30.04.20. It's taken 2/12 for PHE to produce this bullsh*t. When will British BAME HCWs have their George Floyd moment?

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  • The question of why BAME people are more susceptible to developing Covid-19 has been wrapped in social dogma, when the most likely explanation is that there is a genetic predisposition (perhaps a bit like why sickle-cell disease is not a white issue). Research into genetic markers is already being done. I have meanwhile been suggesting for some weeks that NHS BAME staff should be withdrawn from front-line care. See my blogs at https://bamjiinrye.wordpress.com.

    What actually matters would, if addressed, render most of the rest of the issues redundant. If there was an effective treatment that prevented SARS-CoV-2 from developing into Covid-19 we could all stop worrying. Remember AIDS, anyone? Total panic and hysteria because HIV turned unstoppably to AIDS - until a treatment came along. After 40 years there is still no vaccine, so put that on the Covid-19 back burner. Treat the virus? Remdesivir, maybe. Treat what the virus does? Certainly.
    A cytokine storm - for which effective treatment is out there. And, in context, Covid-19 has so far "killed" less than half the number who died from the 1968 flu epidemic, but I fear many readers may not remember that.

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  • You have to be living in some cloud cuckoo land to pretend racism is not endemic in NHS at EVERY level - from patients to royal colleges, to GMC - the lot.

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  • Merlin | GP Partner/Principal04 Jun 2020 9:44am
    "I'm staggered that anyone thought that a government review would actually come up with a solution."

    - Unfortunately, the entire Left think that, and even some on the Right. Libertarians like me are far too few.

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  • Let's be honest. The NHS, it's managers, the CCG, the CQC regulators,the GMC - it's all a toxic degrading superficial farce. They set you up to fail, and still send you into Hot Hubs. To burn. It's an embarrassing employer, with no transparency, no duty of candour or whistle-blowing. Flawed and diseased integrally.

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  • What is happening in Bangladesh?

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  • Vinci Ho

    Well
    I bet the prime minister is praying right now that Mr Sharma does not test positive for Covid 19

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  • In Bangladesh they're sending all the white doctors to front line while ensuring they are back of the queue for training, PPE and safeguarding. When they breathe a word of dissent about the ensuing carnage they ask What is happening in the UK?
    policenthieves, keep voting tory and polishing the brass buttons on your blazer while waiting for the days of empire to return. Or you could try reading Reni Eddo-Lodge "Why I'm No Longer Talking About Race"

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  • Should we just all stop the "Blame gaming," "point scoring" and "Racism agenda" right now. The virus [I suspect] isn't racist but it may affect different races differently and it may effect different races in different countries differently; if any of that makes sense? I am not an academic, just old. There is clearly an observational fact that any frontline ICU doctor will reiterate; serious illness [and therefore death rates] is higher in the BAME population. Do we need an enquiry into this? Do we need an enquiry into why age is factor? - NO WE DONT. At this stage of our understanding of the [New] virus we just need to include BAME as a risk factor as we do with Age, Diabetes, Heart disease, etc and apply the same rules. If BAME people therefore need to wear a mask in public then advise them so. If they need to stay in lockdown longer than "Jo White" then so be it but for everyone sake STOP politicising and blame gaming this unfortunate situation. Surely our real concerns, with this finding [in the UK] should be; what is happening in Bangladesh and the African continent?- shouldn't it?

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